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Benefits for temporary incapacity for work

Benefit for temporary incapacity for work
The benefit for temporary incapacity of work is monetary compensation paid to insured persons on the basis of a certificate of incapacity of work, if the person foregoes social-taxed income due to a temporary exemption from work. The procedure of paying the benefit for temporary incapacity for work depends on the type of the certificate of incapacity of work and the causes of the incapacity of work.

Sickness benefit

In case of illness, quarantine, non-work and traffic injury and the complications or illnesses caused by it, the benefit is paid by the employer from day 4 to day 8. Since day 9, the benefit is paid by the Health Insurance Fund. In other cases (occupational disease, occupational accident (incl. traffic-related occupational accident and complications or illness caused as a result of an occupational accident), injuries caused as a result of protecting national or public interests and preventing a criminal offence), the benefit is paid only by the Health Insurance Fund and from the second day of the exemption from work. 
 
Furthermore, the benefit is paid by the Health Insurance Fund as of the second day if the reason for the certificate of incapacity of work is the provision of work corresponding to the person’s state of health and transferring the person to a less strenuous position, or if the employer does not have work suitable for a pregnant woman. If the employer does have less strenuous work that the employee could do during the period of incapacity for work caused by the above, then the Health Insurance Fund shall compensate the difference in wages caused by the transfer to lighter work since the first day of the certificate of incapacity of work.

The benefit paid by the employee is based on the employee’s average wages during the last six months; the benefit paid by the Health Insurance Fund is based on the social tax paid for the employee during the calendar year preceding the illness (the relevant data can be obtained from the Estonian Tax and Customs Board.

Care allowance

Care allowance is paid by the Health Insurance Fund in the amount of 80% since the first day of exemption from work.
 
Maternity benefit

Maternity benefit is paid by the Health Insurance Fund in the amount of 100% since the first day of exemption from work.

Adoption benefit

Adoption benefit is paid by the Health Insurance Fund in the amount of 100% since the first day of exemption from work.

The benefit for temporary incapacity for work is paid on the basis of a certificate of incapacity for work for a person who is insured through an employer or a contractual partner under the law of obligations, or as a self-employed person.
 
The benefit for temporary incapacity for work is calculated from official income. If the employee receives undeclared wages, then the benefit he or she receives is smaller. Read more about the risks and losses related to undeclared work from the homepage of the Estonian Tax and Customs Board.

If you are looking for information on the proceedings of your certificate of incapacity for work, visit the State Portal at www.eesti.ee or call the Health Insurance Fund’s short number 16363 or calling from abroad, +372 669 6630.

An insured person shall not be entitled to receive benefit from the Health Insurance Fund, if:
  • The illness or injury of the person or of the person under his or her care was caused by the person’s intent or is a result of intoxication; 
  • The person or the person under his or her care ignores medically justified treatment determined by a doctor, thus impeding recovery;
  • The temporary incapacity for work begins at a moment when the insured person is on holiday.
An insured person shall not be entitled to receive benefit from the Health Insurance Fund from the day of the violation, if:
  • He or she fails to keep an appointment with a doctor at the agreed time without good reason;
  • He or she performs duties of employment during the temporary incapacity for work and receives social-taxable income for it or acts as an entrepreneur. 
An insured person who is entitled to maternity or adoption benefit is not entitled to receive sickness benefit or care allowance for the same period of time.
An insured person who is entitled to sickness benefit is not entitled to receive care allowance for the same period of time.